2023 Volume 44 Issue 2 Pages 131-142
Autistic spectrum patients who could not smoothly accept the oral examination at the first visit were given behavior modification, and the factors that influence the effect of behavior modification were investigated. The subjects were 41 out of 81 patients with autism spectrum disorder who visited our clinic for the first time from April 2019 to December 2022 and could not accept the oral examination smoothly. Parents were interviewed about chronological age, gender, developmental age, severe behavioral disorders, disability characteristics, past dental treatment experience, and medical treatment experience. The relationships among the acquisition/non-acquisition of adaptive behaviors in the 13 steps and survey items were analyzed and examined by Fisher’s direct probability calculation and decision tree analysis. As a result of the analysis, the effects of behavior modification were associated with：six developmental ages；the total score of severe behavior disorder；“strange voice”；“stereotypic behavior”；“hypersensitivity”；and “experience of medical restraint”. All subjects with a developmental age of 2 years 7.5 months or older in language comprehension and no “stereotypic behavior” showed an effect of behavior modification on the 13 steps. It is suggested that people with ASD whose language comprehension development age is 2 years 7.5 months or older and who do not have “stereotypic behavior” may be able to undergo oral examination and tooth surface cleaning with a polishing brush. This shows that people with ASD can understand dental instruments and overcome the fear of past experiences of medical restraint.
The effects of behavior modification on ASD patients were considered to be dependent on developmental age, and the characteristics of ASD hindered the effects of behavior modification. If people with ASD can accept oral examination and polishing, they can receive regular checkups at their local dental office without restraint. These results could serve as a guideline for receiving regular checkups in the community.
